The statistics are stark. Forty-seven percent of Canada’s COVID-19 deaths are in Quebec even though the province makes up just 22.5 per cent of Canada’s population. There are now more deaths in Quebec than in neighbouring Ontario, which has six million more people.

Quebec is looking a lot like the epicentre of Canada’s COVID-19 epidemic.

And what we’re seeing isn’t pretty. Two staff for 137 elderly residents, infection spreading like wildfire, patients left for days in their own filth, corpses found in their beds days after death. Thirty one suspected pandemic deaths in one suburban Montreal care home.

Meanwhile, in the province’s hospitals, the situation is relatively stable. Supplies of personal protective equipment (PPE) remain sufficient and hospitalizations and ICU admissions appear manageable, thanks to the efforts of public health authorities and tireless hospital workers. François Legault’s Quebec government has taken full credit for this careful planning in its daily public briefings. Talk has even turned to slowly relaxing some social distancing measures.

Yet it’s becoming increasingly clear that the province’s preparations for COVID-19 had a major and deadly blind-spot: the welfare of Quebec’s institutionalized senior citizens. Fearing a situation in which hospitals would be overwhelmed, as in Italy and Spain, Quebec focused on freeing up hospital and ICU capacity, and in some cases preventatively transferred seniors out of hospitals into care facilities. At the same time, it established recommendations to those care facilities restricting the transfer of residents back to hospitals should they fall ill.

The result has been a humanitarian disaster of still undetermined proportions, which is unfolding as we speak. The first death from COVID-19 in Quebec happened in a retirement residence in mid-March (a further five residents of the facility subsequently died from COVID-19) and the disproportionate impact of the disease on the elderly and those with underlying health conditions was known before the pandemic hit Quebec. There was good reason to expect that seniors would be very vulnerable.

Nonetheless, the government continued to withhold information about the impact of COVID-19 on elder care facilities in the province and refused to disclose which facilities were affected, save for the 6 worst hit public homes, even as they admitted the number of facilities with COVID-19 cases was rising by the hundreds. The public, and residents’ families, were anxiously left in the dark. Journalists have been the ones to sound the alarm by exposing the hellish conditions in the province’s elder care facilities.

The situation is rapidly catching up to the Legault government, as it announced that two private facilities were being placed under trusteeship and named an emergency expert panel to review the situation of Quebec’s seniors on Good Friday. Premier Legault admitted he was “not proud” of the plight of Quebec’s elderly, as he announced a daily death toll of 48 on April 11th, a provincial record.

It’s been happening elsewhere in Canada and the world, but in Quebec, the long-term care catastrophe is particularly acute, especially relative to the pandemic’s overall impact on the province. Three aspects of Quebec’s situation stand out.

First, the concentration of the pandemic’s brunt on seniors in Quebec is striking — 90 per cent of COVID-19 deaths are in people 70 years or older, and 99 per cent in people 60 years or older. According to public data, 67 per cent of COVID-19 deaths in Quebec have been in public or private nursing homes or retirement residences. Quebec’s high percentage of institutionalized seniors exacerbates this situation. According to statistics for 2018, 18.4 per cent of Quebecers over the age of 75 were living in nursing homes and seniors’ residences compared with just 6.1 per cent in the rest of Canada.

Second, Quebec’s pandemic response policies vis-à-vis care facilities likely made things even worse. Emptying hospitals into care facilities and restricting the transfer out of them may have led Quebec to unwittingly engineer a situation in which facilities could harbour the virus and trap its victims inside to get sick and die.

At the same time, already stretched and underpaid care workers in often poorly managed facilities were doomed to get sick and spread the virus or burn out, leaving residents even more neglected and alone. Reports have emerged of recommendations by the Ministry of Health to drastically limit resuscitation for confirmed or “probable” COVID-19 patients in facilities, a development that makes an already grim situation seem even grimmer.

Third, and perhaps most upsetting, has been the Quebec government’s lack of transparency about the problem, and its insistence on painting a rosy picture as this silent disaster unfolded. We need to pause and think about what it means to tell the public that Quebec is doing better than other countries and flaunt its low hospitalization numbers, while most deaths occur outside of hospitals.

Quebec may have had some success in handling the pandemic, such as strong social distancing policies, and the province’s essential workers and citizens should be proud of their efforts to flatten the curve. But its outsized share of Canada’s deaths is cause for self-reflection, not self-congratulation.

Coronavirus has proven itself to be a cunning foe, finding its way to vulnerable populations wherever they are. In Quebec, the Achilles heel seems to be care homes for seniors. We can’t expect our governments to be perfect in the face of such an enemy: everyone is learning as they go and the challenge is tremendous. But we can and should expect our leaders to be honest and transparent: public trust, and people’s lives, depend on it.

*This column has been updated with more detailed statistics on the number of COVID-19 deaths in Quebec in public or private nursing homes or retirement residences.

The views, opinions and positions expressed by all iPolitics columnists and contributors are the author’s alone. They do not inherently or expressly reflect the views, opinions and/or positions of iPolitics.

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Samuel Freeman is a pediatrician and writer in Montreal. Alan Freeman is an iPolitics columnist and Honorary Senior Fellow at the University of Ottawa’s Graduate School of International and Public Affairs.